外周血T淋巴细胞亚群和维生素D水平与婴幼儿反复喘息及哮喘预测指数的关系研究  

Relationship between peripheral blood T lymphocyte subsets and vitamin D levels with recurrent wheezing and asthma predictive index in infants

作　　者：田军[1] 高志刚[1] 沈佩芳[1] 俞涟芳[1] 潘开宇[1] 许凌帆 Tian Jun;Gao Zhigang;Shen Peifang;Yu Lianfang;Pan Kaiyu;Xu Lingfan(Hangzhou xiaoshan first people' s hospital (xiaoshan first hospital affiliated to hangzhou normal university), Hangzhou, Zhejiang,311200, China)

机构地区：[1]杭州市萧山区第一人民医院(杭州师范大学附属萧山第一医院),浙江杭州311200

出　　处：《当代医学》2018年第35期1-4,共4页Contemporary Medicine

基　　金：杭州市卫生科技计划(一般)项目(2017B15)

摘　　要：目的研究外周血T淋巴细胞亚群、维生素D水平与婴幼儿反复喘息及哮喘预测指数的相关性。方法本研究对象为2015年6月至2017年6月期间本院收治的120例反复性咳喘患者,其中API阳性组患者57例,API阴性组患者63例,对所有患者进行回顾性调查,调查内容主要包括家族咳喘史、既往咳喘史、变应原过敏原接触史、外周血嗜酸性粒细胞比例、潮气量参数等,分析患者的API情况。结果 API阳性组患者的CD3^+(%)、CD4^+(%)、CD8^+(%)、CD4^+/CD8^+水平明显低于API阴性组,API阳性组患者CD19+(%)水平明显高于API阴性组(P<0.05);API阳性组患者的IgE、EOS%水平明显高于API阴性组患者,API阳性组患者的25(OH)D_3水平明显低于API阴性组患者(P<0.05);API阳性组患者的TPEF/TE、VPEF/VE、T1水平明显低于API阴性组患者,API阳性组患者的BF、MV水平明显高于API阴性组患者(P<0.05);通过对患者的API多因素logistic回归分析,CD4^+/CD8^+过低、CD19+(%)过高、25(OH)D_3过低、IgE过高、EOS%过高、TPEF/TE(%)过低、VPEF/VE(%)过低为影响患者API阳性率的主要危险因素。结论 API阳性患者T淋巴细胞亚群紊乱失调,血清维生素D降低、潮气量参数中TPEF/TE、VPEF/VE水平明显下降,在反复性咳喘患者诊断中可明显弥补API指数定性分析的缺点,通过定量分析,确定患者的诊断以及治疗效果,值得临床治疗中关注。Objective To study the relationship between peripheral blood T lymphocyte subsets and vitamin D levels with recurrent wheezing and asthma predictive index in infants.Methods In this study,120patients with recurrent cough and asthma were treated in our hospital from June2015to June2017.Among them,57cases of API positive group and63cases of API negative group were reviewed.The main contents of the investigation included the family cough and asthma history,the history of cough and asthma,the history of allergic allergen contact,and the eosinophilia of peripheral blood.Granulocyte ratio and tidal volume parameters were used to analyze the API status of the patients.Results The level of CD3+(%),CD4+(%),CD8+(%)and CD4+/CD8+in the positive group of API was significantly lower than that in the negative group,and the level of CD19+(%)in the API positive group was significantly higher than that in the negative group(P<0.05),and the IgE in the negative group was significantly higher than that of the negative group,and the level of25(OH)D3in the positive group was significantly lower than that of the negative group.The patients(P<0.05),the level of TPEF/TE,VPEF/VE and T1in the API positive group were significantly lower than those in the API negative group.The level of BF and MV in the API positive group was significantly higher than that in the API negative group(P<0.05).By API multivariate logistic regression analysis of patients,low CD4+/CD8+,CD19+(%),25(OH)D3,high IgE,high EOS%,low TPEF/TE(%),VPEF/VE(%)were the main risk factors affecting the API positive rate.Conclusion The T lymphocyte subgroup disorder in API positive patients,the decrease of serum vitamin D and the level of TPEF/TE and VPEF/VE in the parameters of tidal volume,can make up for the shortcomings of the qualitative analysis of the API index in the diagnosis of the patients with recurrent cough and asthma.The diagnosis and treatment effect of the patients are determined by quantitative analysis.

关 键 词：咳喘预测指数 血清维生素D 外周血T细胞亚群 潮气量参数 气道反应 

分 类 号：R725.6[医药卫生—儿科]